10 Questions You Should to Know about rigid endoscopes

We employ six reprocessing techs, with three assigned every day to the decontamination room. Our techs rotate through dual functions and also work in the patient care area, where they help turn over rooms, stock supplies, bring patients to the procedure room and assist patients to their cars after surgery.

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Three of our techs are certified registered central service technicians (CRCSTs), and three learned on the job. We make sure they all receive comprehensive education and training about scope handling ' much of it from the manufacturer. When we onboard a new tech, our vendor rep provides their initial training; they go over the scope anatomy with them and make sure they understand the entire reprocessing process. We then send new techs to a conference our vendor conducts that provides a full day of training on infection control guidelines and scope anatomy, handling and reprocessing. Internally, we provide additional training and competency checks. The goal is to educate techs about the scope manufacturer's guidelines, and those from the Society of Gastroenterology Nurses and Associates (SGNA) and American Society for Gastrointestinal Endoscopy (ASGE). We even designate a preceptor to make sure the new tech properly follows all aspects of our reprocessing.

Laminated signage in the reprocessing area reinforces our education and training, and the scope manufacturer's guidelines are readily available to staff. Our nurse manager and I maintain an open-door policy and encourage staff to ask if they're ever in doubt about reprocessing protocols. 

You want to protect techs from fatigue and soreness from all the repetitive motion of the job. We bought ergonomic anti-fatigue mats for the decontamination room, and chairs for when there's downtime. Our staffing model gives techs a 30-minute lunch and two 15-minute breaks. If somebody needs an extra break, a floating tech can stand in. Since I've been here, our staff engagement scores have been 94% to 98%. 

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Even the most efficient protocols should be regularly reviewed. To ensure compliance, hold quarterly endoscope cleaning audits for the techs and nursing staff involved in your reprocessing, and ask yourself the following questions:

' Do they don appropriate PPE?
' Do they fill the sink with water to the appropriate line?
' Do they perform leak testing?
' Is leak testing performed before detergent is added?
' Is leak testing performed for 30 seconds while angulating in all directions under water?
' Is the appropriate amount of detergent added?
' Do they brush all the channels per policy?
' Do they complete the cleaning process without pausing to take a clean scope out?
' Do they check the high-level disinfectant in the AER to confirm the fluid is still good?
' Did they don a clean apron and gloves to remove the scope from the AER?

'Tammy Richardson, RN, BSN, MHA

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